'Holiday heart' and other drinking health hazards you should know about before cocktail season

Most people these days are well aware of the dangers of drinking and driving, as well as the career ending potential of drunken displays, alcohol can bring with it a number of health hazards that don't make the headlines.

While the long-term benefits of alcohol have been debated for nearly 30 years, ever since red wine was thought to explain the "French Paradox": the counterintuitive finding that France has low rates of heart disease despite a seemingly unhealthy diet, unfortunately, the red wine theory has not held up well over the years. Studies of resveratrol, the main antioxidant in red wine, have failed to show any benefit.

Often lost in the conversation are the potential dangers of alcohol consumption. Outside of the obvious long-term dangers of alcoholism, abuse and addiction, even occasional social drinkers need to be aware of some dangers to heavy drinking before heading out to their holiday fêtes.

What is "holiday heart syndrome"?

Holiday heart syndrome is a term for a reason. The name was coined in 1978 after doctors in New Jersey started noticing patients showing up to emergency rooms with arrhythmias after bouts of heavy drinking, usually during weekends or holidays. These patients were apparently healthy with no history of heart problems or other risk factors.

The most common arrhythmia seen with holiday heart syndrome is atrial fibrillation, a condition that increases the chance of stroke and often requires people to be on lifelong blood thinners. Fortunately, holiday heart syndrome can resolve if the drinking stops. So despite the widely held belief that alcohol is good for your heart, heavy drinking at a holiday party may be enough to cause an arrhythmia and land you in the hospital.

The risk of alcohol poisoning

Alcohol poisoning is more common than people realize. According to the Centers for Disease Control and Prevention an average of six people a day die from alcohol poisoning and three quarters of them are between the ages of 35-64. Most of them are men.

Alcohol is a central nervous system depressant, so apart from the nausea and vomiting that comes with over drinking, alcohol can slow your breathing, drop your core body temperature and cause seizures. How much alcohol it takes to put your life at risk depends, to a large extent, on your height, weight, when your last meal was and a number of other factors, so every person is different. However, binge drinking is typically defined as more than 5 drinks for men and 4 drinks for women within a short span of time, usually 2 hours. So the safest course of action, if you must imbibe, is to pace yourself and space out your drinks to give your liver time to break down the alcohol.

You can learn more about the signs and symptoms of alcohol poisoning at the CDC's website: https://www.cdc.gov/vitalsigns/alcohol-poisoning-deaths/index.html

The problem with energy drinks

Alcohol and energy drinks are a dangerous mix. Although these combinations have become very popular in recent years, hence the rise of the "vodka red bull".

Research has found that mixing energy drinks with alcohol is linked to high-risk sexual activity. College students who mix energy drinks with alcohol were more likely to engage in sex with a casual partner and be intoxicated while having sex. Other researchers have found that having an energy drink and alcohol cocktail at a bar made subjects three times more likely to leave the bar intoxicated and four times more likely to drive upon leaving the bar. Given that the FDA took a number of pre-mixed caffeinated alcoholic beverages off the market in 2010, this might be one cocktail to avoid during the holiday festivities.

Drink size

The key to enjoying alcohol responsibly is moderation, but many people overestimate what one serving of alcohol truly is. Basically, one serving of beer should be 12 ounces or 341ml. But the typical pint of beer served in bars and restaurants is 20 ounces or 568ml, roughly 66% more. Put another way, 2 pints of beer is more than 3 standard drinks. Wine also gets underestimated. A standard serving of wine is 5 ounces or 142ml. So a regular 750ml bottle should provide 5 glasses of wine with a little bit left over. Given that most people plan for a bottle to be split between 2-3 people at a dinner party, it seems fair to say that many people are over-pouring.

Cancer risk

Alcohol is linked to seven different types of cancer. In fact a recent statement by the American Society of Clinical Oncology has highlighted the dangers of excessive alcohol exposure. It's estimated that alcohol is responsible for about 5-6% of new cancer cases worldwide and yet most doctors and patients are not aware of the risk. Fortunately, the risk seems to have a linear dose response, meaning that the risk goes up the more you drink. So cutting back helps reduce your risk, although even light drinking carries a small risk increase. Also, some of the cancers linked to alcohol are quite rare and the absolute risk increase may be quite small. Still, someone looking to make a healthy change would probably benefit from cutting back on his or her alcohol consumption.

Christopher Labos is a physician who writes about medicine and health issues. He co-hosts a podcast called The Body of Evidence and tweets at @drlabos.